St. John’s wort induces (increases the activity of) an enzyme called cytochrome P450 3A4. This enzyme metabolizes (breaks down) lots of medicines in the body. If these medicines are taken with St.
5-hydroxyomeprazole is then transformed into 5-hydroxyomeprazole sulfone by CYP3A4. Omeprazole is metabolized directly in part by CYP3A4 to omeprazole sulfone, then transformed into 5 ...